CMS Price Transparency Data

CT scan, lower back (lumbar spine)

Facility: St Vincent's Medical Center

Billing Code: 72131 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72131
Insurance Median: $168
Cash Discount Price: $1,037
vs. Medicare Baseline: 1.57x Medicare

The contracted insurance negotiated median rate for a CT scan, lower back (lumbar spine) at St Vincent's Medical Center is $168. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,037. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.57x the Medicare baseline. Located in 2800 Main St, Bridgeport, CT.

Cash / Self-Pay

$1,037

Average discount available for prompt cash payment at this facility.

Insurance Median

$168

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$106.81

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $106.81 (100%)

Cash / Self-Pay: $1,037 (971%)

Insurance Median: $168 (157%)

Cash: $1,037 (971% of Medicare)

Ins. Median: $168 (157% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $106.81 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance Rate (%)

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group	Contract Rate Range	vs. Medicare Reference
Blue Cross Blue Shield	$43 - $224	40%
Health New England	$43	40%
Molina DBA Connecticare	$43 - $262	40%
Tufts	$43	40%
United	$43 - $168	40%
Aetna	$44 - $213	41%
Wellcare	$44	41%
Cigna	$221	207%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $1,037.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 72131.

Insurance In-Network Protection Plan

Contact your insurance company to confirm St Vincent's Medical Center is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 72131.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.